Thoracic Spine Flashcards
dense layers of collagen fibers and fibrocartilage
fibers in any one layer are parallel and angled around 60-65 deg to the axis of the spine
annulus fibrosis
central portion is gelatinous with proteoglycans, which have a great affinity for water
helps distribute pressure evenly throughout the disk and during load
nucleus pulposus
cover the nucleus pulposus superiorly and inferiorly
cartilaginous and each is circled by apophyseal ring of vertebral body
end plates
causes of mm strains/ ligament sprains in T-spine
lifting, overuse, and/or direct trauma
Treatment for strains/sprains:
- decrease pain and swelling initially
- STM
- joint mobilization
- seated ROM
- prone strengthening
- seated rotations with or without ball
- postural re-ed
excessive loading or chronic loading of intervertebral disc. Rare in T-spine, but does occur.
caused by trauma, degenerative process, chronic postural dysfunction
Herniated nucleus pulposus
Tx for herniated nucleus pulposus:
- postural re-ed
- joint mobs
- traction
- dynamic postural exercise
surgery :(
Post-surgical treatment for herniated nucleus pulposus
- log rolling and BLTs
- bracing TLSO
- scar mobilization
- TA brace exercise
- dynamic stabilization exercises
excessive posterior convexity of the thoracic spine
pain: stress on the posterior longitudinal ligament and chronic adaptive lengthening of the erector spinae musculature
kyphosis
TX for kyphosis
- postural re-ed
- pec stretching
- prone erector exercises
- rhomboid, mid, and lower trap exercises
- may require brace application
fracture of the vertebral body or end plates due to excessive axial compression loads
caused by trauma, or osteoporosis with progressive degeneration, common with progressive kyphosis
compression fractures
Tx for compression fractures after 6 weeks or post op
- stretch and strengthen
- postural re-ed
lateral curvature of the spinal structures
scoliosis
_____ scoliosis is irreversible
structural
______ scoliosis is reversible or can be slowed
non-structural
_____ scoliosis may require a brace worn 24 hrs a day, may require surgery (Harrington Rods).
We must increase mobility, strength to reduce pain for ADLs
structural
______ scoliosis tx: stretch muscles on concave side, strengthen convex side
manual techniques for correction, and must have mobility to allow for therex intervention
non-structural
region along pathway of the brachial plexus from just distal to the nerve roots exiting the intervertebral foramen to the lower border of the axilla
thoracic outlet
thoracic outlet borders:
medial =
posteriorly =
anteriorly =
laterally =
medial = scalenus anterior, and posterior and the first rib
posteriorly = upper trapezius and scapula
anteriorly = clavicle, coracoid, pec minor, and deltopectoral fascia
laterally = axilla
compression of the neurovascular bundle resulting in UE pain and neurovascular compromise
thoracic outlet syndrome TOS
test: pt stands and abducts the arms to 90 deg, laterally rotates the shoulder, and flexes the elbow to 90 deg so that elbows are slightly behind the frontal plane. pt then opens and closes hands slowly for 3 minutes
+ if pt suffers ischemic pain, heaviness, weakness, numbness and tingling in arm and hand or is unable to keep arms up
Roos Test for TOS
examiner flexes the pts elbow to 90 deg while the shoulder is extended horizontally and rotated laterally. pt then rotates the head away from test side. examiner palpates radial pulse
if pulse becomes absent +
modified wright test for TOS
examnier locates radial pulse
pts head is rotated to face the test shoulder. pt extends head while examiner laterally rotates and extends shoulder. pt takes deep breath and holds it
+ if pulse disappears
Adson Maneuver test for TOS
